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Background <p>Passive range of motion (PROM) is a common early mobilization technique in intensive care, especially for sedated, mechanically ventilated patients. This study aimed to evaluate the effect of early PROM on oxygen consumption (VO₂) and carbon dioxide production (VCO₂) in mechanically ventilated critically ill adults.</p> Methods <p>A prospective observational cohort study was conducted in the tertiary ICU of a university hospital between May and September 2023. PROM was initiated within 24–48 hours of admission in hemodynamically stable, sedated patients (RASS: -2 to -4). A physiotherapist performed a standardized 10-minute PROM protocol. VO₂ and VCO₂ were measured via indirect calorimetry before, during, and after the intervention. Statistical analyses were conducted using a repeated-measures ANOVA, with the average level before and after the measurement, as well as the peak level of VCO₂ during the intervention. Cardiovascular parameters were also recorded.</p> Results <p>Twenty-three patients were included. PROM exercises showed a significant quadratic trend in VCO₂; F = 6.686, <i>p</i> = 0.017 and a borderline quadratic trend in VO₂ (F = 4.320, <i>p</i> = 0.050). Heart rate decreased significantly compared to baseline (<i>P</i> = 0.043). No significant change in blood pressure levels was observed.</p> Conclusion <p>Early PROM exercises in sedated, mechanically ventilated ICU patients induced a quadratic trend in VCO₂ and VO₂, indicating a temporary and reversible metabolic response. PROM does not cause any hemodynamic instability. It accelerates the elimination of metabolic waste and can be used as part of early rehabilitation protocols.</p>

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Metabolic and hemodynamic responses to early passive range of motion in sedated critically ill adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月8日

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  • Turgay Altunalan,
  • Ahmet Oğuzhan Küçük,
  • Umut Apaydın,
  • Ömer Faruk Şahin,
  • Mehtap Pehlivanlar Küçük

摘要

Background

Passive range of motion (PROM) is a common early mobilization technique in intensive care, especially for sedated, mechanically ventilated patients. This study aimed to evaluate the effect of early PROM on oxygen consumption (VO₂) and carbon dioxide production (VCO₂) in mechanically ventilated critically ill adults.

Methods

A prospective observational cohort study was conducted in the tertiary ICU of a university hospital between May and September 2023. PROM was initiated within 24–48 hours of admission in hemodynamically stable, sedated patients (RASS: -2 to -4). A physiotherapist performed a standardized 10-minute PROM protocol. VO₂ and VCO₂ were measured via indirect calorimetry before, during, and after the intervention. Statistical analyses were conducted using a repeated-measures ANOVA, with the average level before and after the measurement, as well as the peak level of VCO₂ during the intervention. Cardiovascular parameters were also recorded.

Results

Twenty-three patients were included. PROM exercises showed a significant quadratic trend in VCO₂; F = 6.686, p = 0.017 and a borderline quadratic trend in VO₂ (F = 4.320, p = 0.050). Heart rate decreased significantly compared to baseline (P = 0.043). No significant change in blood pressure levels was observed.

Conclusion

Early PROM exercises in sedated, mechanically ventilated ICU patients induced a quadratic trend in VCO₂ and VO₂, indicating a temporary and reversible metabolic response. PROM does not cause any hemodynamic instability. It accelerates the elimination of metabolic waste and can be used as part of early rehabilitation protocols.